Provider Demographics
NPI:1992943013
Name:SHAIR, SUZANNE (PT)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:
Last Name:SHAIR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:477 FDR DR
Mailing Address - Street 2:#M1901
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10002-2062
Mailing Address - Country:US
Mailing Address - Phone:917-721-4522
Mailing Address - Fax:212-475-2021
Practice Address - Street 1:473 FDR DR
Practice Address - Street 2:STOREFRONT
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10002-2024
Practice Address - Country:US
Practice Address - Phone:212-475-2000
Practice Address - Fax:212-475-2021
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015866-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist